Korean J Pain. 2016 Jul;29(3):158-63. doi: 10.3344/kjp.2016.29.3.158. Epub 2016 Jul 01.

Presentation of Neurolytic Effect of 10% Lidocaine after Perineural Ultrasound Guided Injection of a Canine Sciatic Nerve: A Pilot Study.

The Korean journal of pain

David D Kim, Asma Asif, Sandeep Kataria

PMID: 27413480 PMCID: PMC4942643 DOI: 10.3344/kjp.2016.29.3.158

Abstract

BACKGROUND: Phenol and alcohol have been used to ablate nerves to treat pain but are not specific for nerves and can damage surrounding soft tissue. Lidocaine at concentrations > 8% injected intrathecal in the animal model has been shown to be neurotoxic. Tests the hypothesis that 10% lidocaine is neurolytic after a peri-neural blockade in an ex vivo experiment on the canine sciatic nerve.

METHODS: Under ultrasound, one canine sciatic nerve was injected peri-neurally with 10 cc saline and another with 10 cc of 10% lidocaine. After 20 minutes, the sciatic nerve was dissected with gross inspection. A 3 cm segment was excised and preserved in 10% buffered formalin fixative solution. Both samples underwent progressive dehydration and infusion of paraffin after which they were placed on paraffin blocks. The sections were cut at 4 µm and stained with hemoxylin and eosin. Microscopic review was performed by a pathologist from Henry Ford Hospital who was blinded to which experimental group each sample was in.

RESULTS: The lidocaine injected nerve demonstrated loss of gross architecture on visual inspection while the saline injected nerve did not. No gross changes were seen in the surrounding soft tissue seen in either group. The lidocaine injected sample showed basophilic degeneration with marked cytoplasmic vacuolation in the nerve fibers with separation of individual fibers and endoneurial edema. The saline injected sample showed normal neural tissue.

CONCLUSIONS: Ten percent lidocaine causes rapid neurolytic changes with ultrasound guided peri-neural injection. The study was limited by only a single nerve being tested with acute exposure.

Keywords: Ablation; Histology; Lidocaine; Nerve; Neurolysis; Pain; Ultrasound

References

1. Arch Phys Med Rehabil. 2000 Oct;81(10 ):1432-5 - PubMed
2. Anesth Analg. 1993 May;76(5):1154-7 - PubMed
3. Int J Rehabil Res. 1999 Dec;22(4):327-9 - PubMed
4. Anesthesiology. 1994 Sep;81(3):657-67 - PubMed
5. Reg Anesth Pain Med. 1998 Sep-Oct;23(5):444-50 - PubMed
6. Reg Anesth Pain Med. 1998 Jan-Feb;23(1):96-100 - PubMed
7. Anesthesiology. 1994 May;80(5):1082-93 - PubMed
8. Anesthesiology. 1999 Feb;90(2):445-50 - PubMed
9. Scand J Rehabil Med. 1973;5(4):160-3 - PubMed
10. Reg Anesth Pain Med. 2012 Nov-Dec;37(6):601-6 - PubMed
11. Acta Anaesthesiol Scand. 2000 Mar;44(3):285-90 - PubMed
12. Pain. 1993 Dec;55(3):363-6 - PubMed
13. Br J Surg. 1970 Jan;57(1):45-50 - PubMed
14. Arch Ophthalmol. 1985 Sep;103(9):1337-9 - PubMed
15. Anesthesiology. 1963 Jul-Aug;24:584-5 - PubMed
16. Reg Anesth Pain Med. 1999 Jul-Aug;24(4):294-302 - PubMed
17. Anesthesiology. 1989 Nov;71(5):757-62 - PubMed
18. Pain. 1978 Oct;5(3):205-29 - PubMed
19. J Anesth. 2005;19(4):328-32 - PubMed
20. Anesthesiology. 1998 Mar;88(3):629-33 - PubMed
21. Int Ophthalmol. 2012 Apr;32(2):191-3 - PubMed
22. Anesth Analg. 2013 Sep;117(3):731-9 - PubMed
23. Anesth Analg. 2009 Mar;108(3):997-1007 - PubMed
24. Anesth Analg. 1998 Mar;86(3):569-73 - PubMed
25. Anesthesiology. 1985 Oct;63(4):364-70 - PubMed
26. PM R. 2009 Sep;1(9):842-51 - PubMed
27. Acta Anaesthesiol Scand. 2007 Jan;51(1):101-7 - PubMed
28. Gastrointest Endosc. 2011 Dec;74(6):1300-7 - PubMed
29. Reg Anesth Pain Med. 2011 Sep-Oct;36(5):444-51 - PubMed
30. J Neuropathol Exp Neurol. 1993 May;52(3):234-40 - PubMed

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